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Changing Ideas in a Changing World: The Revolution in Psychoanalysis - Essays in Honour of Arnold Cooper

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Arnold Cooper has been a consistent innovator and advocate for practical and evidence-based advances in psychoanalysis. This book is inspired by his work and offers refreshing views on changes in the various aspects of the field of psychoanalysis today. 290 pages.

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On Insight and Engagement

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THEODORE J. JACOBS

Psychoanalysis in America is just catching up with Arnold Cooper. Anticipating current developments in our field, from early in his career, Cooper advocated a broad, integrative, and flexible approach to psychoanalysis theory and technique. Consistently emphasizing the link between mind and brain, he was one of the first to recognize the important contributions that neuroscience and psychoanalysis could make to each other. These views made Arnold Cooper a “modern” psychoanalyst many years ago. In fact, one might say that Cooper is an analyst whose time has come.

The view of analysis that characterizes Cooper’s work, however, was not one much appreciated by most of my teachers. At the New York Psychoanalytic Institute in the early sixties, colleagues like Cooper, trained at the camp of the much disparaged Sandor Rado, were regarded as ersatz analysts, that is, psychotherapists who held themselves out to be, but clearly were masquerading as, psychoanalysts.

This was a time in which concern about the assimilation, dilution, and ultimate erosion of Freudian analysis was at its height in traditional institutes. Any departure from classical approach was dismissed as being of little value, and deliberately omitted from the curriculum. Freudian theory, and pretty much only Freudian theory, was taught, and truths about the human mind and its disorders were thought to reside solely in classical analysis and the drive-defence model of mental functioning.

 

On Becoming a Psychoanalyst

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BARBARA MILROD

Arnold Cooper was my residency training director at the Payne Whitney Clinic and the psychiatric world was different when I was a resident. It was possible for a training director, if he chose, to place tremendous emphasis in terms of time and resource allocation to careful clinical education of psychiatric trainees. Arnie expected his residents to perform clinically at their very best at all times. His psychoanalytic background was at the core of what he communicated as an educator. Working with Amie, it was difficult to imagine becoming a solid clinician without having the benefit of a psychoanalytic education.

Nonetheless, long before I first met Arnold Cooper, it was inevitable that 1 would become a psychoanalyst. Both of my parents are psychoanalysts; my father is on the faculty of the New York Psychoanalytic Institute and is a psychoanalytic scholar in superego pathology and depression. My mother is a child analyst. Everything in my home seemed to revolve around psychoanalysis. My parents were excited about psychoanalytic concepts and they viewed so much of the world, from art to people, through an analytic lens. For me, the aura of the field was emotionally charged. The story that I eventually told one of my interviewers when I applied to analytic school was emblematic: my father’s office was located in our home, and as a young child 1 used to sneak out to his waiting room to try to overhear what was happening in his office. I often heard ladies crying. 1 was dying to know what he was doing in there.

 

From Bellowing to Mellowing: My Changing Views on Psychoanalysis Allan D. Rosenblatt

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ALLAN D. ROSENBLATT

I encountered my first psychiatric patient some 50 years ago, as an intern at Los Angeles County Hospital, the first night I was on call on the psychiatric service. I was awakened at 3 A.M. by an ungodly racket, and I rushed from my room onto the ward. There I saw a tiny wizened old lady, with grey straggly hair down to her waist, holding at bay about a half-dozen nurses and attendants. This latter-day witch was spitting at them, wildly brandishing a cane, and screeching epithets and curses in Yiddish, such as “A choleriyah aufdir!”, meaning, “You should contract cholera”, and other more colourful curses, one translated to mean, “You should be like a chandelier - hang by day and burn by night!”

I tried vainly for some time to calm her, but my fledgling professional demeanour eventually crumbled into feelings of helpless frustration. 1 bellowed at her as loud as she was screaming at me, “Soil sein shah!”, roughly meaning, “Shut up!” The effect was magical. She became quite still, shuffled over to me and peered into my face for some moments, then asked quietly, “Are you my brother, Sol?” With all of my 22-year-old authority, I said, “Yes, now go to bed.” And she quietly complied. Thus was I introduced, two years before starting my analytic training, to the power of transference, though not exactly to its analytic use.

 

Current Views on Psychoanalytic Practice

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ALLAN COMPTON

I am a classical psychoanalyst. To me, the statement means that Freud’s fundamental hypotheses - a lawful mind in significant degree outside of conscious awareness, mental conflict and clinical phenomena as compromise formations - remain, in my view, the best available set of hypotheses for understanding human mentation and other behaviour. Further, I mean that set of hypotheses continues to guide my clinical work, which consists of understanding and conveying to my patients the roles of wishes (urges, impulses, drive derivatives), unpleasure affects (anxiety and depression), and defensive operations. In my view, the structure of theory and practice provided by so-called classical analysis, as I have just characterized its scientific basis, remains the substructure, at least, of most of the psychoanalysis practised and taught in the world today: it is still the mainstream, even if in some degree subterranean at this point.

The submerging of adherence to Freudian theory seems to me to be primarily a matter of style at this point. It is common in our field that someone with a new idea believes that dissemination of the idea can be achieved only by insisting that Freudian analysis is wrong, not just a part thereof, but ostensibly all of it. Leo Rangell’s (1997) argument concerning pars pro toto replacement is cogent here: a new and essentially untested theory is offered as a replacement for “classical analysis,” while “classical psychoanalysis” is awarded everything the innovator does not like about psychoanalysis. Much of what is apparently repudiated, however, is kept, while the new theoretical approach, which might well fit in with Freudian theory, is held to replace Freudian theory altogether.

 

The Development of My Ideas about Psychoanalysis

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ROY SCHAFER

Where to begin? Perhaps with the history of the Jews in Eastern Europe and then my parents’ wretched childhoods and emigration to the United States, carrying with them poverty-tainted ideals of learning and little emotional preparation for gratifying family life; this leading to a childhood that featured more than enough bad times emotionally and an adolescence overshadowed by the sense of futility and pessimism engendered in the 1930s by the Great Depression, the rise of fascism, and the massive discrimination against and persecution of Jews - all of which together fostered the deep feelings, “What’s wrong with people?” and “What’s wrong with me?” Under the influence of these feelings I adopted the role of cautious observer, outsider, and interpreter of what people said and did as well as doubter of the meaning and validity of my own ideas and feelings. It was in this soil that there grew my lifelong interest in interpretation, and it is the intensity of this interest that I consider the red thread running through my personal life, my occupational skills, and the development of my ideas about psychoanalysis.

 

The Elusive Wisdom of the Analyst

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ARNOLD GOLDBERG

Waiting to become wise seemed the only possible course. I came to that decision when, as a young analytic candidate surrounded by a variety of sage elders, there seemed to be no clear unambiguous path to pursue to achieve that sought-for state of serenity, knowledge, and peace: wisdom. Convinced as I was of the possession of that precious condition by most, if not all, of my teachers and supervisors, I could not at first fathom how such a diverse bunch of beings had managed to arrive at the same similar and sought-for spot. They were all wise, of that I had no doubt; but that they seemed to manifest different evidence of that state was a matter of temporary puzzlement. One wise teacher, for example, told me never, under any circumstances, to accept any sort of gift from a patient, while another equally prescient one insisted that this should not be a worry. It may even be a benefit to allow oneself to be so gifted. These supposed contradictions were, however, ultimately not the problem, inasmuch as 1 could, with some careful consideration, see that wisdom clearly took different forms at different times. My puzzle had to do with the way to wisdom, that is, just what to do to get there. There seemed to be no easy answer. Finally I decided that reading or studying was not the path, nor was it to be attained by an emulation of my elders, nor was striking out on an original course the proper pursuit. I was left with no alternative but to wait until somehow, in some way, I, too, could lay claim to membership in that elusive circle. This now is the story of that essentially passive journey: its course and its resolution. It is a story with no surprises.

 

Musings about My Intellectual Development

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HERBERT J. SCHLESINGER

In contrast to analysts I have long envied, 1 didn’t read Freud as a boy. We had a good-sized collection of books at home with a fair representation of world literature and leftish political thinking. I knew our well-hidden, brown-paper-wrapped volume of Krafft-Ebing, but we had no Freud. My recollection of first hearing the name is perhaps a screen memory: a radio announcer gravely reported that Freud had died. It was during a broadcast of the New York Philharmonic on a rainy Sunday afternoon. It always rained on Sunday when I was a boy. Freud was described as the author of the recently published Moses and Monotheism. At that time, if there was anyone 1 was less aware of than Freud it was Moses.

My intellectual heroes were Roy Chapman Andrews, who explored for dinosaur fossils in the Gobi Desert, and the naturalists Martin and Osa Johnson. A distant cousin was a bacteriologist, and I loved the word before 1 had any idea what it was about. 1 was stunned by her microscope, binocular and with three objectives. My father gave into my entreaties, and I received an antique model and spent many hours putting anything small enough under it, playing with stains and preparing specimens.

 

A Psychoanalytic Stance

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MILTON VIEDERMAN

The imagined Freud of theory as elaborated in his papers on technique is quite different from the Freud who revealed himself in his clinical work and as revealed by the experience of his analysands. I made first acquaintance with the imagined Freud at the Columbia Psychoanalytic Center where I trained. Its founder, Sandor Rado, had founded the Hungarian Psychoanalytic Society before becoming a major figure in the Berlin Institute. Upon arriving in New York he developed the first curriculum at the New York Psychoanalytic Institute. His repudiation of aspects of classical theory led to controversy and he decided to found a University Institute at Columbia with the idea of bringing psychoanalysis into the mainstream of academia. By the time I began my training his highly authoritarian, anti-classical stance was losing its influence in a faculty that was remarkably eclectic. Yet there was concern about orthodoxy among the candidates. Psychoanalysis was an ideal, an ideal to be achieved through an understanding of theory rooted in Freud’s work and an ideal to be practised in analytic work. It had a purity that was not to be defiled. The analytic situation was seen as having an exquisite sensitivity. Inappropriate “nonanalytic behaviour” could have dire consequences and interfere with a true analysis, for indeed there was a true analysis. My response to this was to be extremely cautious analytically, to defend against my inclination toward spontaneity and to be constricted in my analytic role. Skolnikoff echoes the persistence of this theme among analysts in an unpublished paper in which he speaks of the “analytic conscience”, the sense deeply imbedded in analytic training and practice, that one must avoid deviation from “the rules”. To do so is to deviate from the single prescribed and meaningful analytic stance. The path that I was to take involved an escape from that rigidity to a position of greater freedom with the awareness that appropriate spontaneity not only engages patients who would otherwise not be engaged but generally facilitates the process of analysis.

 

Psychoanalytic Curriculum: A Study in Change and “The Anxiety of Influence”

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ELIZABETH L. AUCHINCLOSS

In 1996, in a panel discussion on psychoanalytic education, I was asked the question: “Should we change our curriculum?” I was delighted with the question because it had become a favourite of mine, having been the first I had asked myself when I became the chairman of the curriculum committee at the Columbia Center for Psychoanalytic Training and Research in 1991. Back in 1991, I found the question to be an exciting one, alive with possibility and opportunity. Gradually it became a preoccupation, evolved into a rumination, and finally developed the haunting quality of a reproach with suggestions of problems overlooked, rigidities, hidden orthodoxies, or just plain laziness. It was not until I was asked the question again, in the panel discussion of 1996, that I was able to organize my thinking and clear up my symptoms.

Ultimately, I came to understand this change in my experience as reflecting a successful if painful transition from an eager new administrator to a member of the establishment. When I began my psychoanalytic education at the Columbia Center in 1980, I was a member of the last class that studied a curriculum designed by Dr. Arnold M. Cooper (1971-1977). For me, therefore, the contemplation of change always begins from the starling place of “the Cooper curriculum”; I have no thoughts about psychoanalytic education that do not bear the mark of his influence. In fact, the most powerful forces for change in curriculum, at least as I have experienced them, have emerged from the struggle to work through what Cooper himself (1997), citing Harold Bloom (1973), has called the “anxiety of influence”. In this chapter, I will discuss aspects of this struggle as well as other forces for change in psychoanalytic curriculum.

 

Change Moments in Therapy

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ETHEL SPECTOR PERSON

Thirty years ago, most American analysts adhered to the drive-conflict model of pathogenesis and believed that change occurred primarily through interpretation, insight, and conflict resolution. They distinguished between facilitative changes - establishment of the therapeutic alliance, intensification of transference through transference interpretation - and definitive changes - identification and internalization, increased awareness of psychic continuity, utilization of insight, and renunciation of infantile wishes.

By the 1970s, a second major psychoanalytic paradigm emerged that encompassed overlapping theories of object relations, self psychology, intersubjectivity, and relational psychoanalysis. It replaced the earlier one-person model with a two-person model, using interactional, interpersonal, and subjectivist paradigms. All emphasize the therapeutic or working alliance as distinct from transference, the emotionally charged therapeutic relationship as a coequal one.

 

Normal and Pathological Narcissism in Women

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EVA P. LESTER

Since Freud’s 1914 original essay “On Narcissism: An Introduction”, narcissistic issues, narcissistic love and object choice, narcissistic pathology, and, ultimately, the very essence of narcissism have been the subject of extensive writings in the psychoanalytic and the psychiatric literature. Furthermore, the terms narcissism and narcissistic have invaded everyday language. By becoming such an over-inclusive concept, narcissism is in danger of losing its theoretical and clinical specificity (Taylor, 1992).

This brief essay will examine the question of normal and pathological female narcissism, as well as the differences between the type of object choice among men and women as proposed by Freud in view of subsequent developments on gender and on the earliest stages of object relations. Freud himself was aware of the many unanswered questions his monograph raised. As quoted by Jones (see the Editor’s Notes for Freud, 1914c), Freud wrote to Abraham, “The Narcissism had a difficult labour and bears all the marks of a corresponding deformation” (p. 70).

 

“Mourning and Melancholia” Eighty Years Later

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OTTO F. KERNBERG

Mourning and Melancholia is Freud’s (1917e) first and fundamental contribution to the psychoanalytic understanding of normal and pathological mourning, the psychopathology of major affective disorders, and the psychodynamic determinants of depression. At the same time, it also marks major developments in psychoanalytic theory at large, particularly the early formulations of the concept of the superego, the fundamental nature of identification processes, and the role of aggression in psychopathology. There are several strikingly original and fundamental propositions in the theory of the psychopathology of depression put forth in “Mourning and Melancholia”. These include the central importance of aggression turned against the self when intensely ambivalent object investments are lost; the role of the superego in this self-directed aggression; the split in the self revealed in the superego’s attack on the ego; and the fusion of another part of the self with an internalized object as the victim of that attack.

 

The Role of Curiosity in Psychoanalysis: Changes in My Technique in the Past Fifteen Years

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EDWARD NERSESSIAN

Some 15 years ago I was confronted for the first time with a patient who, while perfectly willing to say what came to his mind, did not want to think about the meaning of his associations. Whenever I asked him about an aspect of his thoughts, he was in the habit of answering that he was there to tell me everything and it was my job to figure out what it meant. An intensely exhibitionistic and voyeuristic man, he showed no curiosity vis-a-vis his own associations nor vis-a-vis a whole array of symptomatic behaviour. In a certain way, he was pointing out the inadequacy of the so-called “basic rule”. Other patients, when encouraged to say what came to their mind, had spontaneously reflected about it and, therefore, had not provided the opportunity to observe a situation where self-reflection was missing. This patient offered just such an opportunity and this experience was instrumental in my becoming aware of the role of curiosity in psychoanalytic treatment, which resulted in a paper entitled: “Some Reflections on Curiosity and Psychoanalytic Technique” (Nersessian, 1995). Since that time, I have continued to be affected in my analytic work by the attention that I pay to this function and, while it is impossible to hold any one factor as central in one’s clinical development, I think my technique has been strongly affected by this focus.

 

The Shy Narcissist

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SALMAN AKHTAR

Ever since the DSM-III recognized Narcissistic Personality Disorder as a distinct entity, attempts have been made to refine its phenome-nological portrait. An important aspect of these efforts (Akhtar, 1989; Akhtar & Thomson, 1982; Cooper, 1989a; Horowitz, 1989; Kemberg, 1989; Ronningstam, 1988; Ronningstam & Gunderson, 1989) has been to note that the characteristic manifestations of this disorder - grandiosity, exhibitionism, envy, ambition - are sometimes hidden underneath a superficial facade of modesty and shyness. A detailed clinical description of this variant of narcissistic personality disorder, and of its distinctions from the usual flamboyant type, have not yet been provided.

In this paper, I will attempt to delineate the profile of such a “shy narcissist”. I will do so by combining the insights gleaned from (1) revisiting the pertinent material covered in my two earlier reviews (Akhtar, 1989; Akhtar & Thomson, 1982) of the literature on narcissistic personality; (2) relevatu publications by others since my last review of the topic; and (3) my own experience of treating narcissistic patients. I will also highlight the similarities and differences the shy narcissistic personality has with the usual narcissistic personality and certain other personality disorders. I will conclude by commenting upon the implications of recognizing this syndrome.

 

On Abstinence

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DANIEL WIDLOCHER

The principle of abstinence was considered very early by Freud as a basic requirement of the psychoanalytical technique. In “Observations on Transference Love” (1915a) he wrote, “The treatment must be carried out in abstinence” (p. 165) and added, “It [is] a fundamental principle that the patient’s needs and longing should be allowed to persist in her, in order that they may serve as forces impelling her to do work and to make changes. …” (p. 165).

But it is not very clear whether the principle concerns mainly the doctor or the patient. For many years, attention has been paid mainly to the former case, abstinence from the psychoanalyst’s point of view. There is heated debate between “deprivers” and “gratifiers”, the question dealing with “the balance of gratifications and deprivations” that “have to be purposefully employed in the conduct of a psychoanalysis” (Fox, 1984, p. 228). So the question of abstinence is closely related with neutrality (Schachter, 1984) and the debate seems particularly relevant to Freud’s initial concern about the love demands of his women patients (1919a, pp. 159-168).

 

Coming of Age

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KATHERINE DALSIMER

The theme of this volume honouring Arnold Cooper brought to mind a remarkable article by the poet Kenneth Koch (1971).1 It was about teaching children to write poetry. The poet described his experience in a public school in New York City, working with children from first to sixth grades. To begin, he found that it was important to remove obstacles like rhyme and metre, which impede the free flow of feelings and associations. And in an atmosphere that encouraged the young writers to take chances, Koch gave them wonderful subjects to write about: write about your wishes, he told them, write poems that are lies, write about your dreams. But the poems that most delighted me - and that have remained so vivid in my mind all these years - were the poems whose alternate lines began “ I used to … / But now …”:

I used to drive trucks, but now I drive racing cars.
I used to be in first grade
But now I’m in second grade.

I used to have an apple dress
But now it doesn’t fit me.
I used to be a baby saying Coo Coo
But now I say “Hello”
I used to be a goldfish
But now I am a girl.

 

Are the Freuds’ Ego Psychology, Klein’s Object Relations, Kohut’s Self Psychology, and Beck’s Cognitive Psychology All Alive and Well and Living in the Same Brain?

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GEORGE E. VAILLANT

Arnold Cooper has been a life-long synthesizer. In an effort to celebrate his contributions, this essay reflects a homespun effort at synthesis between drive psychology, self psychology, object relations, and cognitive science by an author who is master of none. Nevertheless, this paper will look at Anna Freud’s ego mechanisms of defence from these four vantage points.

In his brief history of the cognitive revolution, Howard Gardner (1985) wrote that a crucial “feature of cognitive science is the deliberate decision to de-emphasize certain factors which may be important for cognitive functioning but whose inclusion at this point would unnecessarily complicate the cognitive-scientific enterprise. These factors include the influence of affective factors and emotions, the contribution of historical and cultural factors and the role of the background context in which particular actions or thoughts occur” (p. 6). In sharp contrast to cognitive science, the Freuds’ ego psychology is principally concerned with Gardner’s three “complicating factors:” emotions, culture, and context. To de-emphasize these factors is to throw the baby out with the bathwater.

 

Psychoanalysis and Empirical Research: A Reconciliation

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LESTER LUBORSKY

There are good historical reasons for the long neglect of empirical research by psychoanalysts. From the point of view of psychoanalysis, empirical research has long been seen as an unnecessary, difficult to comprehend, and even unwelcome intruder. One pattern-setting example of this view occurred in the 1930s. A psychologist in St. Louis, Saul Rozenzweig, in a famous correspondence with Freud, sent Freud some reprints of empirical studies demonstrating the operation of repression. Freud replied that these were interesting, but that he had his own methods of doing things, and that the method presented by Rozenzweig was unnecessary: “I cannot put much value on these confirmations because the wealth of reliable observations … make them independent of experimental verification. Still, it can do no harm” (quoted in Luborsky & Spence, 1971, p. 408; Mackinnon & Duke, 1962). Consistent with Freud’s response, the neglect of empirical research comes from psychoanalysis’s traditional reliance on single case analyses and clinical-theoretical inferences based on what the patient says and does (and Freud may even have been right about these particular supposed analogues of repression called to his attention by Rozenzweig). Freud’s style of investigation also offers an appealing basis to justify the neglect of empirical research on developmental stages as well as on mental functioning - after all, Freud made such world-shaking discoveries, it is natural to consider Freud’s method as the only method; why then should one look elsewhere for a model of method?

 

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